Galveston Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21886 Issued in TX

Legal business name

GALVESTON DENTAL PC

Practice address

5934 Broadway St
Galveston, TX 77551-4305

Phone

(409) 740-7744

Fax

(409) 744-4541

NPI assigned

Mar 30, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kenneth Osamor, DDS

Title

President

Phone

(409) 740-0171

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• AFFORDABLE DENTAL GALVESTON Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1942525209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5934 BROADWAY ST",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775514305",
            "telephone_number": "409-740-7744",
            "fax_number": "409-744-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5934 BROADWAY ST",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775514305",
            "telephone_number": "409-740-7744",
            "fax_number": "409-744-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALVESTON DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-30",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "OSAMOR",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-740-0171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210631201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AFFORDABLE DENTAL GALVESTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Duarte Galvan, LCSW
• Galveston Accident & Injury Clinic
• Galveston Birth Center
• Galveston Broadway Drug LLC
• Galveston Chiropractic
• Galveston Dermatology, P.a.
• Galveston Dermatology, P.a.
• Galveston ER Operations, LLC
• Galveston Independent School District
• Galveston Independent School District

• General Practice Dentistry in Galveston, TX
• Providers in Galveston, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.